Ban on operation for sex change was unlawful

Three transsexuals who took a health authority to court after it refused to pay for sex-change operations won their case in the appeal court yesterday.

The court upheld a high court ruling last December that north west Lancashire health authority's refusal to fund the operations was unlawful. The authority now faces an estimated bill of £150,000 for legal costs - enough to fund 15 or more operations at £8,000 to £10,000 each.

The three litigants, referred to only as A, D and G, were born male but have lived as women for many years. A and G have been assessed by a specialist as having a clinical need for surgery, and D is awaiting assessment. Their solicitor, Stephen Lodge, said the appeal had delayed his clients' treatment and caused them much distress.

"We trust now that the health authority will reconsider its policy and agree to fund our clients' treatment without further delay."

David Edmundson, the health authority's chief executive, said it was too early to say if the three transsexuals would be operated on. "This was never done just because of the cost of treatment. We are saying, we have so much money and we have to ensure it is used as effectively as possible."

The litigants - A, who is aged 21, and the other two, both 50 - were refused an operation in 1996 and in 1997 after it was decided that none of them had shown an "overriding clinical need".

The health authority, which covers Blackpool and Preston, had argued that it was entitled to take into account its own "scarce resources" and refuse funding if it meant that serious illnesses, such as heart disease, cancer, kidney cases, and Aids, were not covered.

Lord Justice Auld said the authority's policy was flawed. It did not treat transsexualism as an illness but "as an attitude or state of mind which does not warrant medical treatment". He added that the authority's attitude to transsexuals amounted to a blanket policy against funding treatment for the condition "because it does not believe in such treatment".

Lord Justice Buxton said that the authority had not shown "rational consideration" before deciding to "give no funding at all to a procedure supported by respectable clinicians and psychiatrists, which is said to be necessary in certain cases to relieve extreme mental distress".

Ms A said she had realised from the age of 10 that she was different from other boys. She regarded her male body as a "deformity". She said: "I don't want to go through surgery, but I have to because if I don't I will probably go mad."